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General NPI Number Information
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NPI Number | 1386793982
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Entity Type | Individual
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Provider Name | BRENDA LITTLE BRUNNER M.A
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1516 W PIONEER PKWY
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City | ARLINGTON
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State | TX
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Zip | 76013-6252
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Country | US
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Telephone | 817-723-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 DEVON DR
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City | COLLEYVILLE
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State | TX
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Zip | 76034-4141
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Country | US
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Telephone | 817-685-7053
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 17576
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License Number State | TX
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